Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY.
Menopause. 2021 Jan 11;28(5):491-501. doi: 10.1097/GME.0000000000001730.
Gut microbiota respond to host physiological phenomena, yet little is known regarding shifts in the gut microbiome due to menopausal hormonal and metabolic changes in women. HIV infection impacts menopause and may also cause gut dysbiosis. We therefore sought to determine the association between menopausal status and gut microbiome composition in women with and without HIV.
Gut microbiome composition was assessed in stool from 432 women (99 premenopausal HIV+, 71 premenopausal HIV-, 182 postmenopausal HIV+, 80 postmenopausal HIV-) via 16S rRNA gene sequencing. We examined cross-sectional associations of menopause with gut microbiota overall diversity and composition, and taxon and inferred metagenomic pathway abundance. Models were stratified by HIV serostatus and adjusted for age, HIV-related variables, and other potential confounders.
Menopause, ie post- versus premenopausal status, was associated with overall microbial composition only in women with HIV (permutational MANOVA of Jensen Shannon Divergence: P = 0.01). In women with HIV, menopause was associated with enrichment of gram-negative order Enterobacteriales, depletion of highly abundant taxa within Prevotella copri, and alterations in other low-abundance taxa. Additionally, menopause in women with HIV was associated with enrichment of metagenomic pathways related to Enterobacteriales, including degradation of amino acids and phenolic compounds, biosynthesis of enterobactin, and energy metabolism pathways. Menopause-related differences in some low-abundance taxa were also observed in women without HIV.
A changing gut microbiome may be an overlooked phenomenon of reproductive aging in women with HIV. Longitudinal assessments across all reproductive stages are necessary to confirm these findings and identify health implications.
肠道微生物群会对宿主的生理现象产生反应，但对于女性因更年期激素和代谢变化而导致的肠道微生物群变化知之甚少。人类免疫缺陷病毒（HIV）感染会影响更年期，也可能导致肠道菌群失调。因此，我们试图确定处于更年期的 HIV 阳性和 HIV 阴性女性的肠道微生物群组成与更年期之间的关联。
通过 16S rRNA 基因测序，评估了 432 名女性（99 名绝经前 HIV 阳性，71 名绝经前 HIV 阴性，182 名绝经后 HIV 阳性，80 名绝经后 HIV 阴性）粪便中的肠道微生物群组成。我们检测了绝经与肠道微生物群整体多样性和组成以及分类群和推断的宏基因组途径丰度的横断面关联。根据 HIV 血清状态对模型进行分层，并调整了年龄、与 HIV 相关的变量以及其他潜在混杂因素。
仅在 HIV 阳性女性中，绝经（即绝经前与绝经后状态）与整体微生物组成相关（Jensen-Shannon 离散度的置换多元方差分析：P=0.01）。在 HIV 阳性女性中，绝经与革兰氏阴性菌目肠杆菌科的富集、Prevotella copri 中高度丰富的分类群的消耗以及其他低丰度分类群的改变有关。此外，HIV 阳性女性的绝经与与肠杆菌科相关的宏基因组途径的富集有关，包括氨基酸和酚类化合物的降解、enterobactin 的生物合成以及能量代谢途径。在 HIV 阴性女性中也观察到一些低丰度分类群与绝经相关的差异。
不断变化的肠道微生物群可能是 HIV 阳性女性生殖衰老被忽视的现象。需要进行所有生殖阶段的纵向评估，以证实这些发现并确定其健康影响。
